Anatomy of the male urinary system (left panel) and female urinary system (right panel) showing the kidneys, ureters, bladder, and urethra.
Adenocarcinoma: Cancer that begins in glandular (secretory) cells that are found in the lining of the bladder. Past treatment with radiation therapy to the pelvis or with certain anticancer drugs, such as cyclophosphamide or ifosfamide. Having a history of bladder infections, including bladder infections caused by Schistosoma haematobium.
Physical exam and history : An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. Urinalysis : A test to check the color of urine and its contents, such as sugar, protein, red blood cells, and white blood cells. Urine cytology : A laboratory test in which a sample of urine is checked under a microscope for abnormal cells. Cystoscopy : A procedure to look inside the bladder and urethra to check for abnormal areas. Biopsy : The removal of cells or tissues so they can be viewed under a microscope by a pathologist to check for signs of cancer. The stage of the cancer (whether it is superficial or invasive bladder cancer, and whether it has spread to other places in the body).
The process used to find out if cancer has spread within the bladder lining and muscle or to other parts of the body is called staging. A procedure that makes a series of detailed pictures of areas inside the body, taken from different angles. Bone scan : A procedure to check if there are rapidly dividing cells, such as cancer cells, in the bone. Bladder cancer is the sixth most common cancer in the United States after lung cancer, prostate cancer, breast cancer, colon cancer, and lymphoma. Under normal conditions, the bladder, the lower part of the kidneys (the renal pelvises), the ureters, and the proximal urethra are lined with a specialized mucous membrane referred to as transitional epithelium (also called urothelium).
Low-grade bladder cancer often recurs in the bladder after treatment but rarely invades the muscular wall of the bladder or spreads to other parts of the body. High-grade bladder cancer commonly recurs in the bladder and also has a strong tendency to invade the muscular wall of the bladder and spread to other parts of the body. Bladder cancer is also divided into muscle-invasive and nonmuscle-invasive disease, based on invasion of the muscularis propria (also referred to as the detrusor muscle), which is the thick muscle deep in the bladder wall. Muscle-invasive disease is much more likely to spread to other parts of the body and is generally treated by either removing the bladder or treating the bladder with radiation and chemotherapy.
Nonmuscle-invasive disease can often be treated by removing the tumor(s) via a transurethral approach, and sometimes chemotherapy or other treatments are introduced into the bladder with a catheter to help fight the cancer. Under conditions of chronic inflammation, such as infection of the bladder with the Schistosoma haematobium parasite, squamous metaplasia may occur in the bladder; the incidence of squamous cell carcinomas of the bladder is higher under conditions of chronic inflammation than is otherwise seen. Exposure to the chemotherapy drug cyclophosphamide has also been associated with an increased risk of bladder cancer. It is important to note that urothelial carcinomas are often multifocal—the entire urothelium needs to be evaluated if a tumor is found.
Patients who die from bladder cancer almost always have disease that has metastasized from the bladder to other organs. Almost all deaths from bladder cancer are among patients with high-grade disease, which has a much greater potential to invade deeply into the bladder’s muscular wall and spread to other organs. There are clinical trials suitable for patients with all stages of bladder cancer; whenever possible, clinical trials designed to improve upon standard therapy should be considered.
Bladder cancer tends to recur, even when it is noninvasive at the time of diagnosis; therefore standard practice is to perform surveillance of the urinary tract after a diagnosis of bladder cancer. An alternative explanation for these patterns of recurrence is that cancer cells that are disrupted when a tumor is resected may reimplant elsewhere in the urothelium.
Locke JR, Hill DE, Walzer Y: Incidence of squamous cell carcinoma in patients with long-term catheter drainage. More than 90% of bladder carcinomas are transitional cell carcinomas derived from the uroepithelium. Pathologic grade of transitional cell carcinomas, which is based on cellular atypia, nuclear abnormalities, and the number of mitotic figures, is of great prognostic importance.
The clinical staging of carcinoma of the bladder is determined by the depth of invasion of the bladder wall by the tumor. Cancer is a disease in which cells in an area of the body begin changing and multiplying out of control.
Each type of tumor can be present in one or more areas of the bladder, and more than one type can be present at the same time. Physical exam and history: An exam of the body to check general signs of health, including checking for signs of disease, such as lumps or anything else that seems unusual. Human papillomavirus (HPV) test: A laboratory test used to check DNA or RNA for certain types of HPV infection.


Cancer may spread from where it began to other parts of the body.When cancer spreads to another part of the body, it is called metastasis.
Stage IIB: Cancer has spread beyond the cervix to the tissues around the uterus but not onto the pelvic wall. A surgical procedure that uses a laser beam (a narrow beam of intense light) as a knife to make bloodless cuts in tissue or to remove a surface lesion such as a tumor.The type of conization procedure used depends on where the cancer cells are in the cervix and the type of cervical cancer.
Surgery to remove the uterus, cervix, part of the vagina, and a wide area of ligaments and tissues around these organs.
Modified radical hysterectomy: Surgery to remove the uterus, cervix, upper part of the vagina, and ligaments and tissues that closely surround these organs.
Radiation therapy is a cancer treatment that uses high-energy x-rays or other types of radiation to kill cancer cells or keep them from growing. Intensity-modulated radiation therapy (IMRT): IMRT is a type of 3-dimensional (3-D) radiation therapy that uses a computer to make pictures of the size and shape of the tumor. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage 0 cervical cancer.
Chemotherapy and targeted therapy.Chemotherapy as palliative therapy to relieve symptoms caused by the cancer and improve quality of life. Check the list of NCI-supported cancer clinical trials that are now accepting patients with stage IVB cervical cancer. Check the list of NCI-supported cancer clinical trials that are now accepting patients with recurrent cervical cancer.
About This PDQ SummaryAbout PDQPhysician Data Query (PDQ) is the National Cancer Institute's (NCI's) comprehensive cancer information database. The information in this patient summary was taken from the health professional version, which is reviewed regularly and updated as needed, by the PDQ Adult Treatment Editorial Board. Clinical Trial InformationA clinical trial is a study to answer a scientific question, such as whether one treatment is better than another.
DisclaimerThe information in these summaries should not be used to make decisions about insurance reimbursement.
Cancer that has spread through the lining of the bladder and invades the muscle wall of the bladder or has spread to nearby organs and lymph nodes is called invasive bladder cancer. Having a risk factor does not mean that you will get cancer; not having risk factors doesn't mean that you will not get cancer. A history of the patient’s health habits and past illnesses and treatments will also be taken. Most cancers that form in the bladder, the renal pelvises, the ureters, and the proximal urethra are transitional cell carcinomas (also called urothelial carcinomas) that derive from transitional epithelium.
As noted above, high-grade cancers are much more likely to be muscle-invasive than low-grade cancers. Radiological studies such as CT scans or ultrasound do not have sufficient sensitivity to be useful for detecting bladder cancers. Patients in whom superficial tumors are less differentiated, large, multiple, or associated with carcinoma in situ (Tis) in other areas of the bladder mucosa are at greatest risk of recurrence and the development of invasive cancer. They tend to grow into the bladder cavity, away from the bladder wall, instead of deeper into the layers of the bladder wall. Sessile tumors are much more likely than papillary tumors to grow deeper into the layers of the bladder wall. Cancer cells break away from where they began (the primary tumor) and travel through the lymph system or blood.Lymph system. A very small amount of cancer that can only be seen with a microscope is found in the tissues of the cervix. In stage IB1, the cancer can only be seen with a microscope and is more than 5 mm deep and more than 7 mm wide OR the cancer can be seen without a microscope and is 4 cm or smaller. Cancer has spread beyond the cervix but not to the pelvic wall or to the lower third of the vagina. Thin beams of radiation of different intensities (strengths) are aimed at the tumor from many angles. For more specific results, refine the search by using other search features, such as the location of the trial, the type of treatment, or the name of the drug.
The PDQ database contains summaries of the latest published information on cancer prevention, detection, genetics, treatment, supportive care, and complementary and alternative medicine.
Thus, muscle-invasive cancers are generally treated more aggressively than nonmuscle-invasive cancers. These patients may be considered to have the entire urothelial surface at risk of cancer development. Small cell carcinomas also may develop in the bladder.[2,3] Sarcomas of the bladder are very rare. Bladder cancer means that certain cells in the urinary tract have changed in ways that aren’t normal. The cancer gets into the lymph system, travels through the lymph vessels, and forms a tumor (metastatic tumor) in another part of the body.Blood.


In stage IA1, the cancer is not more than 3 millimeters deep and not more than 7 millimeters wide. Clinical trials are done to find out if new cancer treatments are safe and effective or better than the standard treatment.Many of today's standard treatments for cancer are based on earlier clinical trials. Each trial answers certain scientific questions in order to find new and better ways to help cancer patients. It cannot be identified as an NCI PDQ cancer information summary unless the whole summary is shown and it is updated regularly. Transitional cell carcinoma (also referred to as urothelial carcinoma) can develop anywhere along this pathway.
The cancer gets into the blood, travels through the blood vessels, and forms a tumor (metastatic tumor) in another part of the body.The metastatic tumor is the same type of cancer as the primary tumor.
Patients who take part in a clinical trial may receive the standard treatment or be among the first to receive a new treatment.Patients who take part in clinical trials also help improve the way cancer will be treated in the future.
During treatment clinical trials, information is collected about the effects of a new treatment and how well it works.
It may also have a tool to remove tissue samples, which are checked under a microscope for signs of cancer.EnlargeCystoscopy.
However, a significant number of transitional cell carcinomas have areas of squamous or other differentiation. For example, if cervical cancer spreads to the lung, the cancer cells in the lung are actually cervical cancer cells. In stage IIA2, the tumor can be seen without a microscope and is larger than 4 centimeters.
If a clinical trial shows that a new treatment is better than one currently being used, the new treatment may become "standard." Patients may want to think about taking part in a clinical trial. A cystoscope (a thin, tube-like instrument with a light and a lens for viewing) is inserted through the urethra into the bladder.
These antibodies can identify substances on cancer cells or normal substances that may help cancer cells grow. Both versions have cancer information that is accurate and up to date and most versions are also available in Spanish.PDQ is a service of the NCI. The longer a person smokes and the more a person smokes, the greater that person’s chances of developing bladder cancer. These abnormal cells may become cancer and spread into nearby normal tissue.Millimeters (mm). The antibodies attach to the substances and kill the cancer cells, block their growth, or keep them from spreading. There are also clinical trials that test new ways to stop cancer from recurring (coming back) or reduce the side effects of cancer treatment.Clinical trials are taking place in many parts of the country.
To avoid exposing the fetus to radiation, MRI (magnetic resonance imaging) is used.Treatment Options for Cervical Cancer During PregnancyCarcinoma in Situ (Stage 0) During PregnancyUsually, no treatment is needed for carcinoma in situ (stage 0) during pregnancy.
The doctor or nurse also inserts a lubricated, gloved finger into the rectum to feel for lumps or abnormal areas.Pelvic exam.
See the Treatment Options section that follows for links to current treatment clinical trials.
A colposcopy may be done to check for invasive cancer.Stage I Cervical Cancer During PregnancyPregnant women with slow-growing stage I cervical cancer may be able to delay treatment until the second trimester of pregnancy or after delivery.
A doctor or nurse inserts one or two lubricated, gloved fingers of one hand into the vagina and presses on the lower abdomen with the other hand. They may be used alone or to carry drugs, toxins, or radioactive material directly to cancer cells.Bevacizumab is a monoclonal antibody that binds to a protein called vascular endothelial growth factor (VEGF) and may prevent the growth of new blood vessels that tumors need to grow. Follow-up tests may be needed.Some of the tests that were done to diagnose the cancer or to find out the stage of the cancer may be repeated. Decisions about whether to continue, change, or stop treatment may be based on the results of these tests.Some of the tests will continue to be done from time to time after treatment has ended.
Surgery or radiation therapy may be done after delivery.Radiation therapy plus chemotherapy.
The results of these tests can show if your condition has changed or if the cancer has recurred (come back). It does not give formal guidelines or recommendations for making decisions about health care.Reviewers and UpdatesEditorial Boards write the PDQ cancer information summaries and keep them up to date. These Boards are made up of experts in cancer treatment and other specialties related to cancer.



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